Things I need to know better...day 1 Flashcards
Patient has persistent Afib and LV systolic dysfunction…develops worsening fatigue, memory loss, weight gain, constipation, and dry skin. Also vague RUQ pain. What drug could be causing this?
Amiodarone –> hypothyroidism and hepatitis
A treated schizophrenic patient has acute dystonic reaction…what is the treatment?
Benzotropine or diphenhydramine
Woman with excess training/malnutrition has amenorrhea with low LSH, normal prolactin, and no withdrawal bleeding after 10d medroxyprogesterone challenge…. what is going on?
Functional hypothalamic amenorrhea –> low estrogen
Patient has blunt trauma to epigastrium and has pain/tenderness afterward…CT is normal and is sent home. Comes back 1wk later with fevers, chills, poor appetite and deep abdominal pain…what is going on?
Pancreatic injury –> abscess
Get a CT
What should you do with an anorexia patient with really low potassium, and/or phosphorus, and/or bradycardia?
Hospitalization
What is a possible end result of vesicouretral reflux?
Recurrent UTIs –> renal scarring
A patient has a mono-like illness with some GI issues and possibly a generalized macular rash…what should be considered?
Acute HIV…check viral load
A kid has multiple fractures, precious puberty, and large cafe-au-lait spots with irregular borders…what is going on?
McCune-Albright syndrome
3Ps
Precocious puberty
Pigmentation
Polyostotic fibrous dysplasia
A kid has mental retardation, seizures, visual impairment, and a port-wine stain over trigeminal area…what is going on?
Sturge-Weber
What cardiac abnormalities does hemochromatosis cause?
Restrictive cardiomyopathy
Conduction abnormalities
Where is the defect with osteogenesis imperfecta?
Type I collagen
A dad is wondering what he can do to best help his daughter who has just been diagnosed with schizophrenia?
Reduce stress at home
What is the most common complication with peptic ulcer disease?
Bleeding
Perforation, penetration, and gastric outlet obstruction can also happen
Person gets stabbed on one side of their spine…where will the contralateral decreased sensation start?
2 levels below injury
A person has rotator cuff injury range of motion…but no pain, just stiffness…what is going on?
Adhesive capsulitis
Patient has isolated thrombocytopenia…what should be looked for?
Viral cause…HBV, HCV, HIV
A mom is in labor, and the kid has variable decelerations…what should be done?
Reposition mom and give oxygen
What is the most common cause of pulseless collapse? What should be done?
Vtach or Vfib
Analyze rhythm and defibrillate
When are live vaccines contraindicated with HIV?
When CD4 less than 200
A patient has renal issues…then develops pericarditis symptoms with nonspecific T wave changes on ECG…what should you look at?
BUN…uremic pericarditis presents with atypical T wave changes
When does a girl with PID need to be kept in patient?
Can’t keep down meds (vomiting)
Can’t trust to take meds
Person has a transfusion…then 2hrs later develops malaise, chills, and a fever with NO signs of hemolysis…what is going on? What could have prevented it?
Febrile Nonhemolytic Transfusion Reaction…caused by cytokines released by residual leukocytes
Could have done a leukoreduction on the transfusion
Patient has CHF s/s with nothing else…no chest pain, rash, or joint pain…what is likely going on?
Viral cardiomyopathy…coxsackie B most likely
Does NOT have to have overall viral presentation
Patient gets an erythematous rash with telangiectasia, papules, and pustules over forehead, cheeks, nose, and chin when drinking hot fluids, going outside on hot sunny days, or when emotional…what is going on?
Rosacea
Patient has back pain for a while, decreased sensation, and a palpable “step off” at lumbosacral region…what is going on?
Spondylolisthesis…forward slip of a vertebra
Patient has s/s of infective endocarditis and splenomegaly…what should be looked for?
Splenic abscess…10-20% caused by IE
What HIV drug causes needle-shaped crystals in the urine?
Indinavir (protease inhibitor)
What HIV drug causes pancreatitis?
Didanosine (NRTI)
What HIV drug causes hypersensitivity syndrome?
Abacavir (NRTI)
What class of HIV drugs cause lactic acidosis?
NRTIs
What class of HIV drugs cause Stevens-Johnson Syndrome?
NNRTIs
What HIV drug causes liver failure?
Nevirapine (NNRTI)
Where is a hemorrhagic stroke most likely to occur?
Basal ganglia (putamen)
Thalamus, pons, cerebellum, and cortex can also happen
Person has GI symptoms…few days go by and they resolve, but now has eye stuff going on, fever, and splinter hemorrhages. What should be looked at on CBC? What could be going on?
Eosinophil count…eosinophilia would indicate parasitic infection
Trichinellosis…might say something about ‘pork’ or ‘Mexico’
What is the most common cause of sepsis in premies?
E. coli
Kid has cerebellar symptoms + decreased vibratory and positional sense + absent ankle jerks + deformed feet with high plantar arches. What is seen on MRI? What is this?
Spinal and cerebellar atrophy
Friedreich Ataxia…autosomal dominant mutation –> codon repeats
What drugs that somebody would use for sleep/anxiety cause a withdrawal seizure?
Short acting benzo…like alprazolam
How do polysaccharide vaccinations work?
T-cell independent B-cell response
How do live attenuated vaccines work?
MMR and influenza –> CD8 proliferation
A person hates population X…does charity to help population X. What is this called?
Reaction formation
What is Ludwig angina?
Oral cellulitis secondary to a tooth infection
Lymphadenopathy and petechiae + pancytopenia + hypo cellular bone marrow with decreased precursor cells (and possibly a lot of fat). What is going on?
Acquired aplastic anemia…caused by injury to bone marrow; can happen at any age
When does Fanconi’s anemia present? How?
Progresses from 4-12yo
Thrombocytopenia –> neutropenia –> anemia
Lots of other things can be going on
What is first line treatment for fibromyalgia?
TCA…SNRI is second line
What is usually found with Conn’s syndrome?
Primary hyperaldosteronism –> hypernatremia, hypokalemia, and metabolic alkalosis (increased bicarb)
Patient’s GI biopsy shows neutrophilic cryptitis. What is going on?
IBD…both Crohn’s and UC has this
Patient keeps getting kidney stones…older relative had same thing going on…hexagonal crystals are seen and the cyanide nitroprusside test is positive. What is going on?
Cystinuria…impaired amino acid transport of basic amino acids (cysteine, lysine, arginine, and ornithine)
